MCQ – 66793

Correct Answer � B Explanation

Ans: B-DOTS

RNTCP and DOTS

• RNTCP ( Revised National Tuberculosis Control Programme) is an application of the WHO-recommended strategy of DOTS in India. It was implemented in 1997.
• The diagnosis is made primarily by sputum microscopy, which is made available free of cost to patients at designated microscopy centers.
• Treatment is provided under direct observation by a DOT 

Objectives:

1- Detecting at least 70% of sputum positive tuberculosis patients in the community.

2- Curing at least 85% of the newly detected sputum positive cases.

Components of DOTS (Directly observed treatment strategy)

1- Political and administrative commitment at all levels.

2- Diagnosis through sputum microscopy

3- Uninterrupted supply of short-course chemotherapy drugs.

4- Direct observation of drug intake ( DOTS)

5- Systematic monitoring, evaluation and supervision at all levels.

Treatment schedule

Category-1:

• *Newly diagnosed sputum positive pulmonary tuberculosis
• *Sputum negative pulmonary tuberculosis with extensive parenchymal involvement.
• *Severe form of extrapulmonary tuberculosis

Category-2

• *Treatment failure cases
• * Relapse cases
• * Return after interruption

Category-3

• * sputum negative pulmonary tuberculosis with minimal involvement
• * Less severe form of extrapulmonary tuberculosis

Drug Regimen

• Category- 1: 2(H3 R3 Z3 E3) 4 ( H3 R3 )
• Category- 2: 2( S3 H3 R3 Z3 E3)+ 1( H3 R3 Z3 E3 ) 5 ( H3 R3 E3)
• Category- 3: 2( H3 R3 Z3 ) 4 ( H3 R3 )

1. H= INH 600mg, R= Rifampicin 450mg, Z= Pyrazinamide 1500mg,
2. E= Ethambutol 1200mg, S= Streptomycin 750 mg.

Treatment in the RNTCP (Revised National TB Control Programme) consists of 2 phases –

• An initial intensive phase and a second continuation phase.
• The total duration of treatment is 6-9 months.

1. The intensive phase lasts for 2-4 months.

• In this phase, a health worker watches as the patient swallows the drugs in his presence. Treatment is given thrice a week on alternate days and every dose is directly observed.

2. The continuation phase lasts for 4-5 months depending on the patient’s response to treatment. 

• In this phase, the first dose of the medicine every week is taken by the patient under direct observation, while the other doses are taken by the patient himself. The patient is requested to bring the previous week’s blister pack when coming to collect the next week’s blister pack.

The color of boxes (containing the drugs for the full course of treatment) is according to the category of regimen : –

• Category I patients —> Red.
• Category II patients —> Blue.
• Category III patients –> Green